Juniper Village at Aurora

A relicensure and complaint revisit was completed on 8/28/2024 for all previous deficiencies cited on 4/18/23. Deficiencies were cited.The regulations governing Assisted Living Residences were revised, and the new regulations were implemented on 7/1/24. Based on interview and record review, the agency failed to ensure its quality management program (QMP) documented and implemented improvement strategies, affecting 45 current residents.This deficiency was previously cited during a re-licensure survey completed on 4/18/23. Although the residence corrected the deficiency, based on the findings below, the residence has not maintained compliance with this regulatory requirement. Findings include:1. Record Review a. On 8/28/24 at 7:30 a.m., QMP documentation was requested and not received during the onsite survey.2. InterviewsOn 8/28/24 at 9:30 a.m., the director of wellness stated she was unaware of the residence implementing a QMP and the residence did not have meetings regarding a QMP.On 8/28/24 at 3:00 p.m., the administrator stated she did not know what a QMP was and acknowledged there was no QMP. She also stated she did not have a reason as to why the deficiency had not been corrected. Based on observation, record review and interview, the residence failed to ensure the house rules addressed cooking, protecting valuables, pets, visitors, telephone use or use of common areas, affecting 45 current residents. This deficiency was cited previously during a state license survey on 4/18/23. Although the residence corrected the deficiency, based on the findings below, the residence has not maintained compliance with this regulatory requirement. Findings include: Chapter VII regulations governing assisted living residences, part 13.3, requires that the assisted living residence establish written house rules and place them in a publicly visible location so that they are always available to residents and visitors.On 8/28/24 at 8:30 a.m., an environmental tour of the residence revealed the residence' s posted house rules, dated 1/4/21. However, these posted house rules that were made available to residents and visitors did not include all required elements including: cooking, protecting valuables, pets, visitors, telephone use or use of common areas. On 8/28/24 at 9:34 a.m, the administrator stated the posted house rules were all the residence had developed, and they did not have anything else. The administrator later stated this deficiency that was previously cited was not corrected because it should have been done at the corporate level. She acknowled..

A licensure complaint, prompted by #CO32990, was completed on 8/14/23. Deficiencies were cited. Based on interview and record review, the residence failed to be responsible for complying with authorized practitioner orders associated with medication administration, affecting three of four sample residents (#1, #3, #4).Findings include:1. Resident #4 was admitted to the residence on 6/3/22.A written practitioner order, dated 3/27/23, directed the residence to administer olanzapine 5 mg once daily. However, the August 2023 medication administration record (MAR) read the number nine on 8/7 and 8/8/23 with no progress note written. The back of the MAR read the number nine which indicated "see progress note". However, there was no progress note written. Therefore, the medication was not administered for a total of two doses.On 8/14/23 at approximately 2:13 p.m., the administrator stated the number nine on the MAR indicated staff should have written a progress note. However, she stated since there was no progress note written regarding the medication administration on 8/7 and 8/8/23, it meant the medication was not administered as required and the resident missed a dose.2. Resident #3 was admitted to the residence on 9/1/21 with diagnoses including osteoarthritis. A written practitioner order, dated 9/9/22, directed the residence to administer vitamin D 50 mcg once daily. However, the July 2023 MAR read the number nine on 7/24/23... Based on interview and record review, the residence failed to ensure any orders received from medical staff on behalf of an authorized practitioner were countersigned by said practitioner as soon as possible, affecting one of four sample residents (#2).Findings include:1. Resident #2 was admitted to the residence on 2/24/20 with diagnoses including dementia.A written practitioner order, dated 3/27/23, directed the residence to administer Seroquel 100 mg before bed. However, the residence received a verbal order on 6/13/23 for Seroquel 50 mg at bedtime daily.Another written practitioner order, dated 7/10/23, directed the residence to administer Seroquel 50 mg before bed daily. However, the residence received verbal orders on 7/19/23 for Seroquel 100 mg at bedtime.The July and August 2023 medication administration records read in part the residence administered Seroquel 50 mg from 7/1-7/18/23, then Seroquel 100 mg from 7/19-8/13/23. Further, the residence was unable to provide countersigned verbal orders for 6/13 and 7/19/23.A progress note, dated 6/13/23, read in part, the residence received a new order for Seroquel 50 mg at bedtime daily. However, the residence was not able to provide evidence of a countersigned order.A progress note, dated 7/21/23, read in part, the practitioner increased the dosage of Seroquel from 50 mg to 100 mg due to increase..

A relicensure survey with complaint #CO31473 was completed on 4/18/23. Deficiencies were cited. Based on interview and record review, the residence documents, staff information and other records as requested by.. Based on interview and record review, the residence failed to promptly notify the resident' s family and/or legal repr.. Based on observation, interview and record review, the residence failed to ensure the administrator complied with al.. Based on observation, record review and interview, the residence failed to comply with conditions imposed by the de.. Based on observation, record review and interview, the residence failed to ensure the house rules addressed the use .. Based on observation, record review and interview, the residence failed to ensure the process for raising and address.. Based on observation, record review and interview, the residence failed to notify the department of a change in adm.. Based on observation, record review and interview, the residence failed to place in a visible location a list of all staf.. Based on observations, interviews and record review, the residence failed to implement and follow their policy perta.. Based on record review and interview, the residence failed to ensure the administrator and a qualified medication a.. Based on record review and interview, the residence failed to have a readily available current resident roster that in.. Based on record review and interview, the residence failed to have policies and procedures for the identification, re.. Based on record review and interview, the residence failed to provide staff with six hours of general training and edu.. Based on record review and interview, the residence failed to show compliance with Colorado Adult Protective Servic.. Based on record review and interviews, the residence failed to request, prior to staff hire, a name-based criminal his.. Based on record review, observation and interview, the residence failed to ensure each first aid kit contained, at a .. Based upon record review and interview, the residence failed to ensure the quality management plan (QMP) containe.. Based upon record review and interview, the residence failed to ensure the quality management plan (QMP) containe.. THIS PORTION OF THE REPORT IS FOR INFORMATIONAL PURPOSES ONLY. No response is necessary. The re..

A licensure revisit was completed on 4/19/23 for all previous deficiencies cited on 2/1/23. The residence is in compliance with all regulations surveyed. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A licensure complaint, prompted by #CO29408 was completed on 2/1/23. Deficiencies were cited. Based on interviews and record review, the residence failed to hold regular family council meetings at least quarterly, affecting 40 current residents.Findings include:On 2/1/23 the RN consultant provided family council meeting notes dated 1/12, 4/20, and 7/13/22.On 2/1/23 at 9:25 a.m., the RN consultant stated the last family council meeting was canceled due to construction in the residence.On 2/1/23 at approximately 2:13 p.m., the director of wellness stated the last family council meeting was in July 2022. She added she was aware the residence was required to hold family council meetings quarterly. Based on observation, interview, and record review, the residence failed to make available personal services, affecting one of six sample residents (#18).Findings include:1. Resident AgreementThe residence' s sample resident agreement, undated, read in part, "The residence provides distinct personal service plans ... Each plan contains different levels of personal assistance and care services depending on the individual needs of the resident."2. Resident #18 was admitted to the residence on 5/23/14.On 2/1/23 from 7:25 a.m. to 8:27 a.m., the portable oxygen tank was empty for on the back of Resident #18' s wheelchair. On 2/1/23 at 1:29 p.m., Staff #15 stated Resident #18 was required to have 4 liters (L) of oxygen at all times. However, he confirmed the resident' s portable oxygen tank was empty earlier that morning because staff forgot to fill it.On 2/1/23 at 2:14 p.m., the wellness director stated the resident required two 2L of oxygen at all times. She stated staff were required to ensure the resident' s portable oxygen tank was filled as required.A written practitioner' s order, dated 12/27/22, directed the residence to administer 2L of oxygen continuously.